Menstrual disorders, what should I do?

This is the 4001th article of Da Yi Xiao Hu

Menstruation is a barometer of women's moods. It comes on time every month, just like the moon in the sky, waxing and waning. When this old friend does not come to us regularly (such as heavy bleeding, frequent menstruation, amenorrhea, etc.), some people don't care, while others are very worried. So what does menstrual disorder mean?

To understand what is irregular menstruation, we first need to understand what is normal menstruation?

There are 4 elements of normal menstruation

1. Menstrual cycle frequency

The normal menstrual frequency is 21 to 35 days. Less than 21 days is frequent menstruation, and more than 35 days is oligomenorrhea.

2. Regularity of menstrual cycle

The difference between adjacent menstrual cycles should not exceed 7 days.

3. Length of menstrual period

A normal menstrual period should last 3 to 7 days.

4. Amount of menstrual bleeding

The normal menstrual volume is 5~80ml. Less than 5ml is called oligomenorrhea, and more than 80ml is called menorrhagia.

If your "menstruation" is not within the above range, and a professional doctor has performed a gynecological examination and has ruled out bleeding from the vulva, vagina, cervix, urinary tract and anus, and the bleeding is limited to the uterine cavity, it can be called abnormal "menstruation", or more accurately abnormal uterine bleeding.

What to expect when abnormal uterine bleeding occurs

1. If your menstruation is usually very regular, but this month's menstruation is delayed or there is spotting, it is likely related to abnormal pregnancy such as miscarriage, ectopic pregnancy, hydatidiform mole, choriocarcinoma, etc. The easiest way is to buy a urine test strip to check whether you are pregnant. Of course, going to the hospital for a blood test for HCG is more accurate, because the incidence of ectopic pregnancy is relatively high, so if you encounter this situation, it is best to go to the hospital immediately for further examination and a clear diagnosis.

2. During this period, menstruation is completely irregular, either the menstrual period is prolonged or the menstrual cycle becomes shorter. In short, there is no pattern to be found. Possible problems at this time:

① There may be some diseases that can cause irregular bleeding, such as endometrial polyps, adenomyosis, uterine fibroids, endometrial lesions, etc. These need to be ruled out one by one through relevant examinations. Some can be controlled by drugs, while others require surgery.

② If the above organic lesions are excluded, it is related to anovulation. A woman with normal menstruation ovulates every month. Only with ovulation can normal female hormones - estrogen and progesterone be secreted, and menstruation can be normal. If there is no ovulation, there will be a lack of progesterone, which will cause menstrual disorders. It is more common in: polycystic ovary syndrome, reduced ovarian reserve function, premature ovarian insufficiency, abnormal thyroid function, etc.

3. Intracranial tumors can also cause menstrual disorders: When a tumor grows in the brain, it will affect women's ovulation abnormalities and also cause menstrual disorders, among which tumors that secrete prolactin are more common. In fact, relatively speaking, this is a good thing, because when menstrual disorders are found, going to the hospital for treatment can early detect pituitary microtumors and timely treatment to avoid further growth of the tumor, and the outcome is often relatively good; for men, because there is no such specific and sensitive sign as menstruation, they are often taken seriously only when symptoms of intracranial hypertension appear. However, when they come to the hospital for treatment, most of them have become pituitary macroadenomas.

4. Tumors that secrete sex hormones: Some tumors that can secrete hormones, such as ovarian granulosa cell tumors, theca cell tumors, and adrenal gland tumors that secrete androgens, can affect ovulation and cause menstrual disorders because they can secrete hormones such as estrogen and androgen.

5. Thyroid and adrenal diseases can also cause menstrual disorders due to the impact on ovulation;

6. Abnormal weight: Being too fat or too thin will affect ovulation and menstruation;

7. Other diseases that cause abnormal uterine bleeding, such as blood system diseases; iatrogenic bleeding caused by the use of contraceptives, warfarin or intrauterine contraceptive devices; cesarean section incision diverticulum, etc.;

If you have menstrual disorders, don't take it lightly. Go to the hospital for treatment in time to avoid a minor disease becoming a major disease, or a major disease becoming an incurable disease! So from a certain perspective, menstrual disorders are early warning devices for many diseases, which is not a "good thing"? At the same time, because there are so many reasons for menstrual disorders, when you have menstrual disorders, the doctor will give you corresponding examinations. Don't complain about too many examinations at this time. Only by finding out the real causes of the disease one by one can you treat it symptomatically.

Menstruation needs to come as scheduled every month. If it does not come as scheduled, there may be some hidden diseases, and you must go to the hospital for diagnosis and treatment; if she can come on time every month, then you can enjoy the pleasure of being alone with her!

Author: Taiyuan Maternal and Child Health Hospital

Reproductive Endocrinology Department